国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2015年
1期
69-71
,共3页
剖宫产术%枕横位%小产钳
剖宮產術%枕橫位%小產鉗
부궁산술%침횡위%소산겸
Cesarean section%Occipitotransverse%Obstetric forceps
目的 探讨剖宫产术中胎头娩出困难时双叶小产钳以枕横位(OT)助娩胎头的可行性及临床价值.方法 选取2007年至2013年期间我院剖宫产术中使用小双叶产钳助的1 16例初产妇为研究对象,其中以枕横位产钳助娩的41例,枕前位的39例,枕后位36例,记录胎头娩出时间、产钳滑脱情况及母婴损伤情况.结果 在剖宫产术中产钳助娩胎头的1 16例中,胎头娩出时间:枕横位(OT)组(32.65 2.87)s,枕前位(OA)组(45.75±3.58)s,枕后位(OP)组(46.05±3.59)s;子宫切口延长:OT组1例(2.41％)、OA组1例(2.56％)、OP组1例(2.78％);新生儿颜面损伤:OT组1例(占2.4％),OA组3例(7.7％),OP组为4例(占11.1％);产钳滑脱率:OT组0例,OA组3例(7.69％),OP组3例(8.3％).经统计学分析,胎头娩出时间、新生儿颜面部损伤率和产钳滑脱率有统计学意义,而产后出血、子宫切口延长率无统计学意义.结论 剖宫产术中胎头娩出困难时,使用双叶小产钳以枕横位助娩胎头时胎头娩出时间短,且新生儿颜面部损伤及产钳滑脱率均较低,对产后出血以及切口撕裂伤无明显差异,值得在临床上应用推广.
目的 探討剖宮產術中胎頭娩齣睏難時雙葉小產鉗以枕橫位(OT)助娩胎頭的可行性及臨床價值.方法 選取2007年至2013年期間我院剖宮產術中使用小雙葉產鉗助的1 16例初產婦為研究對象,其中以枕橫位產鉗助娩的41例,枕前位的39例,枕後位36例,記錄胎頭娩齣時間、產鉗滑脫情況及母嬰損傷情況.結果 在剖宮產術中產鉗助娩胎頭的1 16例中,胎頭娩齣時間:枕橫位(OT)組(32.65 2.87)s,枕前位(OA)組(45.75±3.58)s,枕後位(OP)組(46.05±3.59)s;子宮切口延長:OT組1例(2.41％)、OA組1例(2.56％)、OP組1例(2.78％);新生兒顏麵損傷:OT組1例(佔2.4％),OA組3例(7.7％),OP組為4例(佔11.1％);產鉗滑脫率:OT組0例,OA組3例(7.69％),OP組3例(8.3％).經統計學分析,胎頭娩齣時間、新生兒顏麵部損傷率和產鉗滑脫率有統計學意義,而產後齣血、子宮切口延長率無統計學意義.結論 剖宮產術中胎頭娩齣睏難時,使用雙葉小產鉗以枕橫位助娩胎頭時胎頭娩齣時間短,且新生兒顏麵部損傷及產鉗滑脫率均較低,對產後齣血以及切口撕裂傷無明顯差異,值得在臨床上應用推廣.
목적 탐토부궁산술중태두면출곤난시쌍협소산겸이침횡위(OT)조면태두적가행성급림상개치.방법 선취2007년지2013년기간아원부궁산술중사용소쌍협산겸조적1 16례초산부위연구대상,기중이침횡위산겸조면적41례,침전위적39례,침후위36례,기록태두면출시간、산겸활탈정황급모영손상정황.결과 재부궁산술중산겸조면태두적1 16례중,태두면출시간:침횡위(OT)조(32.65 2.87)s,침전위(OA)조(45.75±3.58)s,침후위(OP)조(46.05±3.59)s;자궁절구연장:OT조1례(2.41％)、OA조1례(2.56％)、OP조1례(2.78％);신생인안면손상:OT조1례(점2.4％),OA조3례(7.7％),OP조위4례(점11.1％);산겸활탈솔:OT조0례,OA조3례(7.69％),OP조3례(8.3％).경통계학분석,태두면출시간、신생인안면부손상솔화산겸활탈솔유통계학의의,이산후출혈、자궁절구연장솔무통계학의의.결론 부궁산술중태두면출곤난시,사용쌍협소산겸이침횡위조면태두시태두면출시간단,차신생인안면부손상급산겸활탈솔균교저,대산후출혈이급절구시렬상무명현차이,치득재림상상응용추엄.
Objective To explore the feasibility and clinical value of delivering fetal head with occipitotransverse(OT) using obstetric forceps when having difficulty in delivering fetal head in cesarean section.Methods 116 primiparas,obstetric forceps were used in whose cesarean section,were selected from our hospital from 2007 to 2013; of which,41 cases took occipitotransverse (OT) position,39 occipitoanterior (OA),and 36 occipitotransverse (OP).The fetal head disengagement time,forceps slip,and perinatal injury were recorded.Results The mean fetal head disengagement time was (32.65 ±2.87) s in the primiparas with OT,and (45.75±3.58) s in those with OA,and (46.05±3.59) s with OP.One primipara's incision extended in each group,respectively.One newborn (2.4％) got facial injury in OT group,and 3 (7.69％) in OA group,and 4 (11.1％) in OP group.The forceps slip rate was 0.0％ in OT group,7.69％ (3 cases) in OA group,and 8.3％(3 cases) in OP group.The statistical analysis showed that there were statistical differences in fetal head disengagement time,neonatal facial injury and forceps slip rate but no statistical differences in postpartum hemorrhage and uterine incision extending rate between the 3 groups.Conclusions Delivering fetal head with occipitotransverse(OT) using obstetric forceps when having difficulty in delivering fetal head in cesarean section can shorten fetal head disengagement time and lower neonatal facial injury rate and forceps slip rate,has little effect in postpartum hemorrhage and incision laceration,and is worth be clinically generalized.
